Drug interactions
Fluticasone-salmeterol + Voriconazole
Severity: Major
Fluticasone-salmeterol and Voriconazole: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Voriconazole strongly inhibits CYP3A4 and can raise systemic fluticasone and salmeterol exposure. This may cause Cushing's syndrome and adrenal suppression with fluticasone, and increased cardiovascular and QT effects with salmeterol.
What this interaction means in plain words
Fluticasone-salmeterol and Voriconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Fluticasone-salmeterol belongs to Respiratory; Voriconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition reduces first-pass and systemic metabolism of fluticasone and salmeterol, with additive QT effects.
What to do
Consider an alternative corticosteroid such as beclomethasone and monitor ECG and potassium if coadministration is needed. Watch for signs of hypercortisolism with prolonged use.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Fluticasone-salmeterol
- Darunavir + Fluticasone-salmeterol Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Fluticasone-salmeterol Contraindicated
- Fluticasone-salmeterol + Fosamprenavir Contraindicated
- Fluticasone-salmeterol + Indinavir Contraindicated
- Fluticasone-salmeterol + Lopinavir Contraindicated
- Fluticasone-salmeterol + Nelfinavir Contraindicated
Other interactions of Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Fluticasone-salmeterol with Voriconazole?
MediHelp rates the interaction as major. Fluticasone-salmeterol and Voriconazole can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Voriconazole strongly inhibits CYP3A4 and can raise systemic fluticasone and salmeterol exposure. This may cause Cushing's syndrome and adrenal suppression with fluticasone, and increased cardiovascular and QT effects with salmeterol.
How serious is the interaction between Fluticasone-salmeterol and Voriconazole?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an alternative corticosteroid such as beclomethasone and monitor ECG and potassium if coadministration is needed. Watch for signs of hypercortisolism with prolonged use.
What other medicines interact with Fluticasone-salmeterol?
MediHelp also lists interactions of Fluticasone-salmeterol with, for example, Darunavir, Elvitegravir / cobicistat / emtricitabine / tenofovir df, Fosamprenavir. The full list is on the Fluticasone-salmeterol page.
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